November 23, 2003

In the last day, I've been contemplating survival.

No doubt that internship is physically, psychologically, and morally taxing; and that there are more enjoyable--and perhaps fruitful--ways of spending a year of one's life. Yet some of us manage without becoming too embittered while others become "toxic" and frustrated. What's the difference?

Internship is a necessary evil. Unfortunately 90% of one's time and effort is spent doing rather unenlightening things--but you still have to go through it because the remaining 10% you just can't get anywhere else except by being the junior house officer on the line at 3 am when your patient's urine output and blood pressure are sinking.

The "operational tempo" of being your patients' primary caregiver--to borrow a military term--forces us to interact with other people to a level uncommon in other professions. I enjoy these interactions on the whole, and the good ones far outweigh the bad ones in my mental balance. For instance, there's a nurse that I've become good friends with that I'd be ecstatic to work with as my Nurse Clinician once I've built a practice. I think you can develop lasting professiona/personal relationships if you try to maintain a reasonably positive outlook in your life as an intern.

One intern told me yesterday that she used the F-word in the middle of a supermarket after the cashier refused to accept her check for 12 bags of groceries. "I'm never like that!"

Another fellow intern asked me how I put up with it especially since I'm a bit older and could easily have chosen a different career path.

I don't know.

I can only guess that some mechanism in me extracts or perceives the good things over the bad things. I wish I had a formula.

Perhaps it's the little things. After rounding my patients a second time in the late morning and checking their labs, I walked over to the Duke Gardens. And looking across the greensward, with squirrels stirring the leaf litter behind me, an Indian Summer sun, the gothic edifice of Duke South rising in the distance, I could feel the knots loosening a little, probably just enough for me to maintain my sanity.

Posted by erich at 06:38 AM